An investigation into interpersonal forgiveness and its effects on a variety of psychological wellbeing outcomes : a mixed methods study

Background: Understanding about factors that can improve psychological wellbeing is important because such wellbeing is linked to the prevention of mental and physical illness, improved learning and educational attainment, and greater work productivity. Whilst there is a growing body of research highlighting the role of forgiveness in improving some aspects of mental health, few studies have examined its relationship to a variety of psychological health outcomes. Even fewer studies have explored the process of state forgiveness, particularly among under-studied religious/spiritual and nonreligious/spiritual samples outside of a US context. Methods: To address these gaps, a mixed methods study was undertaken and applied in three phases. In phase one, I conducted qualitative interviews to explore how participants practiced interpersonal forgiveness, the mechanisms that facilitated and obstructed this process, and perceptions about the effects of choosing to forgive in response to being hurt. In phase two, I tested the qualitative study results by conducting an internet survey study of under-studied samples within a UK context to explore links between state (real life) forgiveness and wider dimensions of wellbeing as well as testing for any moderator effects. In phase three, I conducted a systematic review of the effectiveness of forgiveness-based interventions. RCT studies were retrieved using electronic databases and reference sections of previous reviews; each study was assessed for risk of bias. Standardized mean differences and confidence intervals were used to assess treatment effects. Results: The results of the qualitative study indicated that factors that assisted forgiveness entailed accepting responsibility, meditation, prayer, a focus on positive qualities, beliefs in being spiritually connected with others, talking, as well as the offender making amends. Key barriers to forgiveness were blame, not feeling understood or acknowledged, powerlessness, constantly thinking about the hurt, wanting revenge, ongoing transgressions and a need for physical distance. All interview participants described experiencing a variety of benefits as a result of forgiving such as reductions in negative affect, increases in event-specific and general positive emotions, a sense of meaning and purpose in life, positive relations, empowerment as well as spiritual development. The qualitative results also suggested that forgiveness entailed a shift from negative resentment based emotions, thoughts and behaviours towards an experience of positive regard for the offender. Differences were also identified in relation to conditional and unconditional forms of forgiveness. The survey data was analysed using hierarchical multiple regression analysis. The results of the survey suggested that forgiveness significantly predicts some components of mental wellbeing (i.e. eudaimonic) over and above the level of variance accounted by other important variables such as age, employment, meditation and connectedness. The survey results did not indicate that connectedness and meditation moderate (or mediate) the association between forgiveness and wellbeing. Results of the review showed that forgiveness interventions reduce depression, stress and distress as well as promote general positive affect. The results also indicated a low to moderate quality of evidence. Conclusion: In conclusion, the results of this research project suggest that forgiving a variety of real life interpersonal offenses can facilitate the reduction of a range of mental health problems, promote general positive emotions and increase eudaimonic wellbeing. This study also suggests that a range of mechanisms can act to assist or hinder state forgiveness and indicated important differences in how forgiveness is practiced, and the influence this can have on psychological functioning. Further research is, however, needed

Expression and sequence characterization of growth hormone binding protein of Nili-Ravi buffaloes (Bubalus bubalis)

The growth hormone binding protein (GHBP) was isolated from the liver of Nili-Ravi buffaloes (Bubalus bubalis), reverse transcriptase-polymerase chain reaction (RT-PCR) amplified and sequence characterized. RT-PCR analysis demonstrated high degree sequence identities (97.3 to 99.6%) of BbGHBP cDNA with Bos taurus, Ovis aries and Capra hircus. An expression plasmid was constructed for the production of BbGHBP in Escherichia coli BL21 (RIPL) CodonPlus under the control of T7lac promoter. On induction with isopropyl β-D thiogalactopyranoside, the BbGHBP was expressed at levels >30% of the total E. coli proteins. The target protein expressed as inclusion bodies was solubilized in denaturing solution and refolded by step/pulsatile dilution method using cysteine and cystine redox potential. Purification to near homogeniety (>98%) was achieved by ion-exchange chromatography with a recovery yield of 64%. Mass spectrometric analysis of the purified BbGHBP showed a single peak of 30,756 Da. A radioprotein assay evaluated the binding affinity of recombinant BbGHBP with iodinated bovine growth hormone (bGH) which demonstrated active conformation of BbGHBP. These results demonstrate high expression and sequence characterization of BbGHBP in Nili-Ravi buffaloes and provide the basis for the assessment of BbGHBP in other breeds of buffalo.Keywords: Liver, Nili-Ravi buffalo, GHBP, MALDI-TOF mass spectrometry, radioprotein binding assay, refoldin

SOLITARY FIBROUS TUMOR OF BREAST

Solitary fibrous tumours (SFTs) are fibroblastic mesenchymal tumour primarily identified in the pleura but are now being reported in other anatomic sites as well. SFT is generally characterised as a radiologically confined neoplasm composed of a proliferated spindle cells arranged in patternless manner. Intervening tissue shows prominent haemangiopericytoma-like vessels. Stroma is usually fibrous. Tumour is positive for CD34. SFT has a specific translocation representing fusion NAB2 with STAT6 genes. This translocation can be highlighted with very good specificity and sensitivity using STAT6 immunohistochemical stain. Some cases of SFTs have also been described in the breast. Rarely, SFT can show aggressive behaviour. SFT enters the differential diagnoses of benign and malignant spindle cell tumours of breast and it is, therefore, important that its clinical, radiological and pathological features are known to clinicians and diagnosticians. Key words: CD34, myofibroblastoma, NAB2-STAT6, solitary fibrous tumou

Quality of life after functional endoscopic sinus surgery in patients with chronic rhinosinusitis

Chronic Rhinosinusitis (CRS) is a group of disorders characterized by the inflammation of mucosa of the nasal passages and paranasal sinuses. It includes chronic rhinosinusitis with polyps, CRS without polyps and Allergic Fungal Sinusitis (AFS). This debilitating disease causes negative impact on quality of life (QOL) of patients. Functional endoscopic sinus surgery (FESS) is the mainstay of surgical treatment for patients and improves QOL of patients. This subjective assessment of QOL can be measured by disease specific questionnaires. SNOT-22 questionnaire is widely used and validated questionnaire for this purpose. Prospective study was done on 54 patients. Data were collected using SNOT-22 questionnaire and filled in pre-operative period then in post-operative follow-up visits on 1st, 3rd, 6th and 12th months. Paired sample t-test was used to compare pre-operative and post-operative SNOT scores and multivariate generalized linear model was used to estimate regression parameters for SNOT scores in CRS with polyp and AFS in comparison of CRS without polyps. Out of 54 patients, 59.3% were males, mean age was 35.98, 29.6% were in CRS without polyp group, 44.4% and 25.9% were in CRS with polyps and AFS group. Recurrence occurred in 7.4%, revision surgery required in 3.7% while 22.2% had history of asthma. Paired sample t-test showed statistical significant reduction in post-operative SNOT scores. Linear model results showed SNOT scores in CRS with polyp group was significantly reduced. Thus FESS provides significant improvement in QOL of patients in chronic rhinosinusitis

Surgical site infection; effect of contamination and duration of surgical procedure

Introduction: Surgical site infections are responsible for increased treatment cost, prolonged hospital stay and increased morbidity on surgical floor. Increased level of per operative contamination and prolonged surgery increases the incidence of surgical site infections.Objective: To know the effect of contamination and duration of surgery on the incidence of surgical site infections in emergency surgical patients so that specific strategies can be developed to decrease the morbidity and mortality caused by these infections.Materials and Methods: All the patients who underwent general surgical operations on an emergency basis at the surgical unit-1 of the Benazir Bhutto Hospital Rawalpindi from 01-01-2019 to 31-12-2020 were evaluated for surgical site infections. The level of contamination per operatively and duration of surgery were documented. Surgical site infections suspected clinically were confirmed by culture and sensitivity.Results: Among 2202 emergency-operated patients, two hundred and thirty-seven patients (10.76%) had surgical site infection confirmed on culture and sensitivity (C/S) report. About sixty-five percent of patients were male. Of two hundred and thirty-seven positive patients, seventy (29.09%) patients underwent laparotomy for penetrating and blunt abdominal trauma. About fifty-eight percent of SSI patients had contaminated wounds per operatively. Operative time was one to three hours in about sixty-seven percent of SSI-positive patients. Staph aureus was present in one hundred and forty-five (79.67%) patients. E.coli was the most commonest Gram-ve micro-organism (70.95%).Conclusion: Surgical site infection causes a significant rise in morbidity on the surgical floor. Increased levels of contamination per operatively and prolonged operative time increase the incidence of SSI in emergency surgical operations

Enhanced production of subtilisin of Pyrococcus furiosus expressed in Escherichia coli using autoinducing medium

A subtilisin gene identified in the reported genome sequence of Pyrococcus furiosus was amplified and inserted in pET-22b(+) vector to produce the recombinant plasmid pET-SB. Escherichia coli BL-21 (DE3)CodonPlus was transformed with this plasmid and the enzyme was expressed up to 30% of the total cell protein on induction with IPTG. The expressed protein appeared at a position corresponding to ~20 kDaon SDS-PAGE as compared to theoretical molecular mass of 17.6 kDa. This aberrant electrophoresis mobility could be due to specific amino acid composition of the protein. Auto-induction with lactose also produced a similar level of expression but the total amount of the enzyme produced was 2.4 foldgreater than that when produced with IPTG induction. This was due to a higher cell density obtainable in the auto-inducing medium. The enzyme expressed in the insoluble state could be partially refolded after denaturation with urea at high pH. This study reports for the first time high-level expression ofsubtilisin of P. furiosus in E. coli using an auto-inducing medium

Surgical site infection; effect of contamination and duration of surgical procedure

Introduction: Surgical site infections are responsible for increased treatment cost, prolonged hospital stay and increased morbidity on surgical floor. Increased level of per operative contamination and prolonged surgery increases the incidence of surgical site infections.Objective: To know the effect of contamination and duration of surgery on the incidence of surgical site infections in emergency surgical patients so that specific strategies can be developed to decrease the morbidity and mortality caused by these infections.Materials and Methods: All the patients who underwent general surgical operations on an emergency basis at the surgical unit-1 of the Benazir Bhutto Hospital Rawalpindi from 01-01-2019 to 31-12-2020 were evaluated for surgical site infections. The level of contamination per operatively and duration of surgery were documented. Surgical site infections suspected clinically were confirmed by culture and sensitivity.Results: Among 2202 emergency-operated patients, two hundred and thirty-seven patients (10.76%) had surgical site infection confirmed on culture and sensitivity (C/S) report. About sixty-five percent of patients were male. Of two hundred and thirty-seven positive patients, seventy (29.09%) patients underwent laparotomy for penetrating and blunt abdominal trauma. About fifty-eight percent of SSI patients had contaminated wounds per operatively. Operative time was one to three hours in about sixty-seven percent of SSI-positive patients. Staph aureus was present in one hundred and forty-five (79.67%) patients. E.coli was the most commonest Gram-ve micro-organism (70.95%).Conclusion: Surgical site infection causes a significant rise in morbidity on the surgical floor. Increased levels of contamination per operatively and prolonged operative time increase the incidence of SSI in emergency surgical operations

Comparison of open vs Plastibell techniques of circumcision for surgical outcomes and cosmetic satisfaction;A randomized control trial

Objective of the study: To compare the results of circumcision by open technique and the Plastibell technique in male babies. Methods: In this randomized controlled interventional study, 1440 babies whose circumcision was done as religious rite were divided into two groups. Group A underwent circumcision by open technique whereas group B underwent circumcision by Plastibell method. Results: Majority 720 (50%) were in age group 6-8 weeks. Compared with open method, significantly less number of patients in plastibel method experienced moderate pain (47.91% versus 35% p value .00001 and severe pain 31.94% versus 9.02% p value .00001.Rate of wound infection was significantly less in plastibell method 2.77% versus 4.86% p value .020. However more patients in plastibell technique needed re-do circumcision 4.02% versus 1.94% p value .0202. Overall greater parent’s satisfaction was attained with plastibel method. Conclusion: Plastibell technique has many advantages over open method in terms less post op pain, wound infection, and greater cosmetic  satisfaction however more patients will need re-do circumcision in this technique compared with conventional method. Keywords: Circumcision, open technique, Plastibell, post-op complication